2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T6fb,Cascade genetic testing in families with hereditary cancer syndromes is an important strategy to reduce the burden of cancer, but testing of relatives is low. Direct engagement of relatives through cancer survivors is a promising approach to bridge this gap. We conducted a population-based cluster-randomized clinical trial (Genetic Information and Family Testing [GIFT]) of an online, direct-to-family, cancer genetic education and communication tool including the offer of home testing to adult relatives of cancer survivors diagnosed in 2018-2019 who carried a pathogenic variant. We selected patients through SEER and surveyed them for eligibility followed by a trial invitation. Two features were randomized: assistance from a human navigator (yes, no) and testing cost (free Four thousand three hundred patients were surveyed and 2,285 responded (53.1%); 2,006 eligible respondents were invited (87.8%) and 414 enrolled (20.6%). Enrolled patients reported a total of 4,946 first- and second-degree relatives (mean, 12.3; standard deviation [SD], 8.6); they invited 948 relatives (19.2%) and 303 enrolled (32.0%). Most enrolled relatives ordered testing (267, 91.3%); more than double were tested in the free versus $50 arm (odds ratio [OR], 2.5 [1.6-3.9]), but the baseline fraction tested was low at 0.03 and thus the absolute increase was modest (0.04 [95% CI, 0.02 to 0.05]). We did not find evidence for increased testing in the navigation arm (OR, 1.3 [0.8-2.1]). GIFT is a promising blueprint for online cascade genetic education and testing. Results suggest that a low-cost, population-level intervention could be deployed without a human navigator. Additional intervention strategies are needed to increase the modest invitation and testing uptake observed in this study.31:Ta4e, PURPOSE Cascade genetic testing in families with hereditary cancer syndromes is an important strategy to reduce the burden of cancer, but testing of relatives is low. Direct engagement of relatives through cancer survivors is a promising approach to bridge this gap. METHODS We conducted a population-based cluster-randomized clinical trial (Genetic Information and Family Testing [GIFT]) of an online, direct-to-family, cancer genetic education and communication tool including the offer of home testing to adult relatives of cancer survivors diagnosed in 2018-2019 who carried a pathogenic variant. We selected patients through SEER and surveyed them for eligibility followed by a trial invitation. Two features were randomized: assistance from a human navigator (yes, no) and testing cost (free v $50). We hypothesized that the fraction of relatives tested in a family (primary outcome) would be higher with a navigator and free testing. RESULTS Four thousand three hundred patients were surveyed and 2,285 responded (53.1%); 2,006 eligible respondents were invited (87.8%) and 414 enrolled (20.6%). Enrolled patients reported a total of 4,946 first- and second-degree relatives (mean, 12.3; standard deviation [SD], 8.6); they invited 948 relatives (19.2%) and 303 enrolled (32.0%). Most enrolled relatives ordered testing (267, 91.3%); more than double were tested in the free versus $50 arm (odds ratio [OR], 2.5 [1.6-3.9]), but the baseline fraction tested was low at 0.03 and thus the absolute increase was modest (0.04 [95% CI, 0.02 to 0.05]). We did not find evidence for increased testing in the navigation arm (OR, 1.3 [0.8-2.1]). CONCLUSION GIFT is a promising blueprint for online cascade genetic education and testing. Results suggest that a low-cost, population-level intervention could be deployed without a human navigator. Additional intervention strategies are needed to increase the modest invitation and testing uptake observed in this study. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Genetic Counseling / Navigation: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Genetic Counseling / Navigation (modality). Clinician-written summaries and actionable practice insights. 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Enrolled patients reported a total of 4,946 first- and second-degree relatives (mean, 12.3; standard deviation [SD], 8.6); they invited 948 relatives (19.2%) and 303 enrolled (32.0%). Most enrolled relatives ordered testing (267, 91.3%); more than double were tested in the free versus $50 arm (odds ratio [OR], 2.5 [1.6-3.9]), but the baseline fraction tested was low at 0.03 and thus the absolute increase was modest (0.04 [95% CI, 0.02 to 0.05]). We did not find evidence for increased testing in the navigation arm (OR, 1.3 [0.8-2.1]).","abstract":"$30","keywords":[],"pubmed_id":"41875376","conclusions":"GIFT is a promising blueprint for online cascade genetic education and testing. Results suggest that a low-cost, population-level intervention could be deployed without a human navigator. Additional intervention strategies are needed to increase the modest invitation and testing uptake observed in this study.","publication_date":"2026-03-24T00:00:00"},"crossref":{"DOI":"10.1200/jco-25-02196","URL":"https://doi.org/10.1200/jco-25-02196","ISSN":["0732-183X","1527-7755"],"link":[{"URL":"https://ascopubs.org/doi/pdfdirect/10.1200/JCO-25-02196","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":"1216-1224","type":"journal-article","issue":"13","score":1,"title":["Results From the Genetic Information and Family Testing Study: A Cluster-Randomized Trial"],"author":[{"given":"Steven J.","family":"Katz","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, MI"},{"name":"Department of Health Management and Policy, School of Public Health and Department of Internal Medicine, University of Michigan, Ann Arbor, MI"}]},{"given":"Timothy P.","family":"Hofer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, MI"}]},{"given":"Paul","family":"Abrahamse","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, MI"}]},{"given":"Rebecca R.","family":"Courser","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, MI"}]},{"given":"Rachel","family":"Hodan","sequence":"additional","affiliation":[{"name":"Cancer Genetics, Stanford Health Care, Stanford, CA"}]},{"given":"Rachel S.","family":"Tocco","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Michigan, Ann Arbor, MI"}]},{"given":"Sonia","family":"Rios-Ventura","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, CA"}]},{"given":"Kevin C.","family":"Ward","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA"}]},{"given":"Ann S.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, University of Southern California, Los Angeles, CA"}]},{"given":"Melissa K.","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY"}]},{"given":"Lawrence C.","family":"An","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Michigan, Ann Arbor, MI"}]},{"given":"Allison W.","family":"Kurian","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, CA"},{"name":"Department of Epidemiology and Population Health, Stanford University, Stanford, 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Two features were randomized: human navigator assistance (yes vs. no) and testing cost (free vs. $50).","key_result":"Of 4,946 reported relatives, only 19.2% were invited and 32% of those enrolled; 91.3% of enrolled relatives ordered testing. Free testing more than doubled the odds of testing vs. $50 (OR 2.5, 95% CI 1.6–3.9), but the absolute increase in the fraction tested was modest (0.04, 95% CI 0.02–0.05). Human navigation did not significantly improve testing uptake (OR 1.3, 95% CI 0.8–2.1).","limitations":"Only 20.6% of eligible patients enrolled, limiting generalizability. Patients invited just 19.2% of their relatives, creating a major upstream bottleneck the intervention could not overcome. The absolute baseline testing fraction was very low (0.03), so even a significant relative improvement produced a small absolute gain.","practice_takeaway":"Removing cost barriers (offering free testing) meaningfully increases cascade genetic testing uptake and can be deployed without a human navigator, reducing program complexity and cost. However, clinicians should recognize that most relatives are never invited — strategies to boost patient-to-relative outreach remain the critical gap."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Genetic Counseling / Navigation"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Genetic Counseling / Navigation"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Genetic Counseling / Navigation"}}}]]

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